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快速血糖调节在血糖控制不佳的糖尿病患者中，是夏科氏急性神经关节病病理生理学的一个新的相关因素。

Rapid glycemic regulation in poorly controlled patients living with diabetes, a new associated factor in the pathophysiology of Charcot's acute neuroarthropathy.

机构信息

Department of Diabetes, Sud Francilien Hospital Center, Corbeil-Essonnes, France.

INSERM UMRS 1138, Cordeliers Research Center, Paris, France.

出版信息

PLoS One. 2020 May 21;15(5):e0233168. doi: 10.1371/journal.pone.0233168. eCollection 2020.

DOI:10.1371/journal.pone.0233168
PMID:32437409
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7241699/
Abstract

OBJECTIVE

Aggressive antidiabetic therapy and rapid glycemic control are associated with diabetic neuropathy. Here we investigated if this is also the case for Charcot neuroarthropathy.

RESEARCH DESIGN AND METHODS

HbA1c levels and other relevant data were extracted from medical databases of 44 cases of acute Charcot neuroarthropathy.

RESULTS

HbA1c levels significantly declined from 8.25% (67mmol/mol) 7.1%-9.4%, at -6 months (M-6), to 7.40%(54mmol/mol) [6.70%-8.03%] (50-64 mmol/mol) during the six months preceding the diagnosis of Charcot neuroarthropathy (P <0.001).

CONCLUSIONS

HbA1c levels significantly declined during the six months preceding the onset of Charcot neuroarthropathy. This decline seems to be a associated factor with the appearance of an active phase of Charcot neuroarthropathy in poorly controlled patients with diabetic sensitive neuropathy.

摘要

目的

积极的降糖治疗和快速血糖控制与糖尿病周围神经病变有关。在这里，我们研究了这种情况是否也适用于夏科氏神经关节病。

研究设计和方法

从 44 例急性夏科氏神经关节病的医学数据库中提取了 HbA1c 水平和其他相关数据。

结果

HbA1c 水平从-6 个月（M-6）时的 8.25%（67mmol/mol）[7.1%-9.4%]（54-79mmol/mol）显著下降至夏科氏神经关节病诊断前 6 个月的 7.40%（54mmol/mol）[6.70%-8.03%]（50-64mmol/mol）（P<0.001）。

结论

HbA1c 水平在夏科氏神经关节病发病前 6 个月显著下降。这种下降似乎是糖尿病敏感神经病变控制不佳的患者夏科氏神经关节病活跃期出现的一个相关因素。

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本文引用的文献

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Multifocal (tarsus and knee) activation of neuroarthropathy following rapid glycaemic correction.神经关节病多灶性（跗骨和膝关节）激活，与血糖快速校正相关。
J Diabetes Complications. 2019 Dec;33(12):107438. doi: 10.1016/j.jdiacomp.2019.107438. Epub 2019 Sep 12.
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Treatment-Induced Neuropathy of Diabetes.糖尿病治疗引起的神经病变
Curr Diab Rep. 2017 Oct 24;17(12):127. doi: 10.1007/s11892-017-0960-6.
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The Charcot foot: pathophysiology, diagnosis and classification.夏科氏足：病理生理学、诊断与分类
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Charcot neuroarthropathy after simultaneous pancreas-kidney transplantation: risk factors, prevalence, and outcome.胰肾联合移植术后的夏科氏神经关节病：危险因素、患病率及预后
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Role of Wnt/β-catenin and RANKL/OPG in bone healing of diabetic Charcot arthropathy patients.Wnt/β-连环蛋白和RANKL/OPG在糖尿病夏科氏关节病患者骨愈合中的作用
Acta Orthop. 2015;86(4):415-25. doi: 10.3109/17453674.2015.1033606. Epub 2015 Mar 26.
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Treatment-induced neuropathy of diabetes: an acute, iatrogenic complication of diabetes.治疗性糖尿病神经病变：糖尿病的一种急性医源性并发症。
Brain. 2015 Jan;138(Pt 1):43-52. doi: 10.1093/brain/awu307. Epub 2014 Nov 11.
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The development of a charcot foot after significant weight loss in people with diabetes: three cautionary tales.糖尿病患者体重显著减轻后夏科氏足的发生：三个警示故事。
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Increased osteoclastic activity in acute Charcot's osteoarthropathy: the role of receptor activator of nuclear factor-kappaB ligand.急性夏科氏关节病中破骨细胞活性增加：核因子-κB 受体激活剂配体的作用
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